Medical Billing Blog with Medical Billing & Coding Info & Articles
Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.
Bundling Claims Brings Higher Ob-Gyn Reimbursements
Bundling Claims Brings Higher Ob-Gyn Reimbursements Medicare has made several changes to the bundling procedure for Ob-Gyn medical billing. The procedures for bundling codes or not bundling certain current procedural terminology codes when doing medical billing constantly changes for Medicare. In order to receive the highest reimbursement possible, it is necessary to know the correct billing for certain medical current procedural terminology codes. The latest Medicare change deals with current procedural terminology code 57283 (colpopexy, vaginal; intra-peritoneal approach). You can no longer perform separate billing for this medical code and 57280 (Colpopexy, abdominal approach). They are mutually exclusive. This means that if both codes are reported on the same day …
Medical Billing And Second Observation Day Coding
Medical Billing And Second Observation Day Coding Eventually, when you’ve done enough medical billing, you will run across the scenario when a patient is in the hospital on a three day stay, a common belief among medical billers is that the a “middle” day of observation should be billed on the medical billing form as an Outpatient Visit (99212-99215). Many Carriers and Medicare will not reimburse a middle day visit coded in this fashion. Even with documentation for the middle day visit included on the medical billing form. The AMA’s position on the medical coding for this situation is that you report the middle/second day of a three day stay …
Clarifying Guidelines For Medical Billing Cardiac Rehab
Clarifying Guidelines For Medical Billing Cardiac Rehab Difference in medical billing manuals have made cardiac rehab claim submission confusing. There are three manuals that give guidance on how to bill for cardiac rehab services. These manuals are the Medicare Coverage Issues Manual, Intermediary Manual, and Hospital Manual. Each on of these manuals gives a different method on how to bill for cardiac rehab. The Office of Inspector General realizes that this has become a major medical billing issue. Recently, an audit was done on thirty four different hospitals. The goals was to see where the consistencies and then confusion lie in billing for medical cardiac rehabilitation. The results were astonishing! …
Captain Integrity & The Medical Billing Community
Captain Integrity – Superhero For The Medical Billing Community And More! Medical billing compliance has never been more fun. A brand new compliance program called Captain Integrity is getting some positive attention. Medical billing fraud is wrong and Captain Integrity is here to save the day. With medical billing fraud on the rise, a new compliance brand name was in order. The intention of the Captain Integrity program is to put a positive spin on compliance that all employees will enjoy. Many people look at compliance as a negative thing. Captain Integrity wants to change that. Everyone from office personnel to actual physicians can get involved in this medical billing …
California AG Files Fraud Charges Against 39
California AG Files Fraud Charges Against 39 pharmaceutical companies There is big Medical billing news in California. California’s Attorney General, Bill Lockyer, is showing large pharmaceutical companies that they can’t take advantage of his state any longer. Pharmaceutical fraud has plagued California. Inflation of medical billing hurts everyone. On August 25, the medical billing news that swept across California was that the Attorney General filed a lawsuit against 39 large pharmaceutical companies. He claims that they have spent years wrongfully inflating the costs of drugs. The billings for many of these medical drugs were sent to California’s Medicaid (Medi-Cal). Apparently, a smaller pharmacy filed a lawsuit against a few larger …
Strong Documentation Gets Your E/M Claims Paid
Strong Documentation Gets Your E/M Medical Billing Claims Paid When billing a medical claim, the diagnosis code is one of the most important elements to prove medical necessity. As soon as a payer gets a claim, it automatically goes through their system and is either paid, denied, or sent to review. Billing with strong documentation to back up medical current procedural terminology codes will get claims paid quicker. Many times with simple evaluation and management visits, the only thing needed in billing a claim is the medical CPT code and the ICD-9 code. When this is the case, it is very important that these codes not only correctly correspond, but …
Errors In Drug Testing Claims = Visit From the Feds
Errors In Drug Testing Claims Can Put The Feds At Your Door Any type of medical billing error can raise some eyebrows. There have been so many cases of fraudulent claims, there is no longer room for mistakes. Whether you make an unknowing error in medical billing, or purposefully cheat a payer out of money, the government will come after you with full forces. Recently, on August 25, 2005, an osteopath, Aaron M. Hurowitz was indicted on 80 counts of healthcare fraud. This Georgia osteopath had been involved in fraud and money laundering since 1997. Apparently he cheated Medicaid out of about three million dollars. There were several things he …
Outsourcing Your Medical Billing In Texas
Outsourcing Your Medical Billing In Texas Texas is a big State with a lot of people and those people need to see doctors and those doctors need to bill and get reimbursed for those services. This is where outsourcing your medical billing becomes a viable option and good idea. Outsourcing your medical billing will free up your staff and handle your receivables for you. With today’s secured and encrypted information transferring technology, there is no fear of your information not being private and secure. Your records are kept private and in full compliance. Medical billing companies stay up to date on the latest pulse of the medical billing industry and …
Choosing Medical Billing and Coding Training
Choosing Medical Billing and Coding Training Medical billing is a complicated process designed for only the most skilled workers. Although training is necessary, certification is not a requirement. However, choosing the right training program with the correct certifications is the key to success in medical billing. First we will take a look at three of the most notable training programs available for medical billing and coding today. The first program is a web-based program called Universal Class. The great thing about Universal Class is the ability to work at your own pace in a non-credit type of atmosphere. The medical billing courses are taught by knowledgeable instructors at affordable prices. …
Combining HPI and ROS In Your Medical Billing
Combining HPI and ROS In Your Medical Billing Claims Combining history of present illness and review of systems is possible when doing medical billing. Many medical billers think this practice is breaking a rule or impossible. However, documenting an element once to account for HPI and ROS is perfectly legal. Many times a physician will leave a medical billing company with tons of documentation for a review of systems, but not enough information for the history of present illness. Don’t worry! There is no need to down-code. The CMS states that physicians absolutely do not need to document an element two times just so the person performing medical billing knows …
